Would Jesus Expand Medicaid In Missouri? I’ll Let Him Tell You (UPDATED)

“Missouri’s low income and vulnerable citizens will have access to excellent health care in order to maximize their quality of life and independence.”

—The “vision” statement of Missouri’s Medicaid program, MO HealthNet Division

I swear the following story is in your Bible:

On one occasion an expert in the law stood up to test Jesus. “Teacher,” he asked, “what must I do to inherit eternal life?”

“What is written in the Law?” he replied. “How do you read it?”

He answered, “‘Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind; and, ‘Love your neighbor as yourself.’”

 “You have answered correctly,” Jesus replied. “Do this and you will live.”

But the expert in the law wanted to justify himself, so he asked Jesus, “And who is my neighbor?”

In reply Jesus said, “A man was going down from Jefferson City to Joplin, when he found out his job was being outsourced to China. All in one moment he lost his income and along with it his health insurance, which he needed because his wife had a serious health condition. A Religious Right preacher happened to be going down the same road on his way to vote for a Republican, and when he saw the uninsured man on the side of the road in much distress, he passed by on the other side. So too, a Teapartier, when he came to the place and saw him, passed by on the other side, as he was also on his way to vote for a Republican.

But a Samaritan, a man who believed in the social safety net, came by where the man was, and when he saw him, he took pity on him. He went to him and told him not to worry. He told him that he was voting for someone who would make sure that he and his wife had affordable health insurance, whether he had a job or not. He told him that he was voting for someone who would make sure his unemployment benefits wouldn’t dry up before he had a fair chance to get another job. Then he put the man in his car, registered him to vote, and brought him to the polling place. 

“Which of these three do you think was a neighbor to the man who lost his job and his health insurance?”

The expert in the law replied, “The one who had mercy on him.”

Jesus told him, “Go and do likewise.”

Here in Missouri, Republicans have blocked the expansion of Medicaid, which would have been fully paid for by the federal government for the next three years. After that the state would eventually pay no more than 10% of the cost, as the program is fully phased in by 2020. The point is that it wouldn’t cost the state a dime—not a dime—until 2017, and even then it wouldn’t cost much. It is estimated that in 2015 Missouri would receive $1.7 billion to help expand the program and bring insurance to more people who can’t now afford it, which could be somewhere between 260,000 and 310,000 Missourians.

Here is a look at just who would benefit if the program were expanded today, again at no cost to the state:

medicaid expansion in missouri

Right now, without Medicaid expansion in this Jesus-loving state, if you are a parent or parents in a family of four and can’t afford private health insurance but have an income over $4,475 a year (19% of the 2013 Federal Poverty Level), you aren’t eligible for Medicaid. Yes, you read that right. If you preside over a family of four and make over $4,475 a year (a bleeping year!) but don’t make enough to buy health insurance, as a parent you are not eligible for Medicaid in Missouri. If you’re wondering, that cutoff for eligibility is the lowest allowed under the federal law that initially established the national program.

Under expansion, your family situation wouldn’t matter. Neither would your disability status. If you were parenting a family of four and earned up to $31,322 a year (based on 133% of the federal poverty level for 2013), you would be eligible for help if you didn’t otherwise have health insurance. If you were a single adult, you could earn up to $15,282 a year and qualify for health insurance under Medicaid. And as a comprehensive study indicated, the expansion is not only good for the entire state (it would actually bring in more dough to the treasury), but it is especially good for folks who live in places like where I live here in the southwest corner:

medicaid expansion map

See that? Just in our part of the state more than 60,000 of our New Testament-toting neighbors would get health insurance. Hallelujah!

Except that here in this Jesus-loving town of Joplin, here in God-fearing Southwest Missouri, lives the Majority Floor Leader of the Missouri Senate, Ron Richard. I don’t know if he loves Jesus or not, but I do know he is opposed to Medicaid expansion and voted against it last week, as did every single Republican in the Senate. Here are the duties of his august position:

The Majority Floor Leader sets the schedule of bills up for consideration by the full chamber, the time spent on floor debate for legislation, and the meeting times and dates of the Missouri Senate, among other duties.

As you can see, Ron Richard is a powerful man. He can change the dynamics of the debate on the expansion of Medicaid in Missouri in less time than it would take a House Republican to say, “Impeach the socialist in the White’s House!” Below are ways to contact him:

Jefferson City Office, Pattie: 573-751-2173

Joplin Office, Gwen: 417-623-0022

Or send him a message:

http://www.senate.mo.gov/D32WebApps/Contact.aspx
http://ronrichardmosenate.com/contact.php

You can use one or all of the above methods in order to a) ask him if he loves Jesus, or b) ask him if he wants to treat his fellow Missourians like a good neighbor, or c) do what I did and send him a message like this:

ron richard websiteI respectfully ask that Sen. Richard lead the charge on expanding Medicaid in Missouri and bring some relief to hundreds of thousands of Missourians who need health insurance. We are leaving billions of dollars on the table, money that is needed here in our state to care for our own. Do the right thing, please.

_________________________________

UPDATE: Here is the email response I received from Sen. Richard. Based on this response, it wouldn’t hurt for all of you who are interested in this issue to let him know where you stand:

Thank you for your email. This was brought up on the Senate Floor for debate. This was just the first discussion on the floor and I believe there will be a lot more before we have a chance to vote on the bill. I will keep your thoughts and comments in mind as this bill becomes perfected and we vote on the measure.

Please let me know if you have any further questions or concerns.

Sincerely,

Ron Richard
Senator District 32

“Bullet Backstops”

Tea Party freak, Sharron Angle, back when she was trying to take away Harry Reid’s senate seat in 2010, famously said in an interview with a conservative talker, Bill Manders:

Angle: I feel that the Second Amendment is the right to keep and bear arms for our citizenry. This not for someone who’s in the military. This not for law enforcement. This is for us. And in fact when you read that Constitution and the founding fathers, they intended this to stop tyranny. This is for us when our government becomes tyrannical…

Manders: If we needed it at any time in history, it might be right now.

Angle: Well it’s to defend ourselves. And you know, I’m hoping that we’re not getting to Second Amendment remedies. I hope the vote will be the cure for the Harry Reid problems.

Now, Angle—who, by the way, got nearly 45% of the vote in Nevada in her race against Reid—was suggesting, of course, that the right to murder unrepentant Democrats, who she considered to be part of a tyrannical government, was why the Second Amendment exists. And to be honest, a lot of Republicans in power, most in fact, wouldn’t publicly disagree with her Second Amendment logic, even if they would criticize her Second Amendment honesty.

Now comes the latest freak in the Republican Party to endorse the Second Amendment-sanctioned murder of legislators: Chris Nogy. This man is married to the secretary of the Republican Party in Benton County, Arkansas, chris nogywhich is uncomfortably close to Joplin, less than an hour’s drive from my house. Yikes.

Mr. Nogy is proposing the murder of legislators who voted for “socialism” in Arkansas, otherwise known as Medicaid expansion under ObamaCare. In the latest Republican Party of Benton County Newsletter, Nogy wrote (the piece was titled, “Scathing”):

…we need to get a LOT tougher if we are ever to assure that events like those that took place this week don’t happen again.

Part of me feels that this betrayal deserves a quick implementation of my 2nd amendment rights to remove a threat domestic.  Because no matter how much one group says it is inevitable to start down the road to socialism it isn’t as long as we use our creativity and energy to creating solutions that don’t take us that way.

Fortunately for Democrats, and unlike Sharron Angle’s Second Amendment strategy, Nogy is letting Democrats who voted for Medicaid expansion off the hook:

I don’t feel the same way about the Democrats as bullet backstops as I do about the Republicans who joined them.  The Democrats were doing what their party told them they had to do because they were elected to do that job.

Whew!  Thanks Mr. Nogy for at least getting your aim right!

In case you were thinking that Nogy was just kiddin’ around, he wasn’t finished:

We need to let those who will come in the future to represent us that we are serious.  The 2nd amendment means nothing unless those in power believe you would have no problem simply walking up and shooting them if they got too far out of line and stopped responding as representatives.

Damn! That gun-toter is pissed! And he ain’t apologizin’. In a response on the Benton County Republican Committee’s Facebook page, he begins with this:

This is not a retraction, this is a clarification.

After he claimed, falsely, that he “didn’t advocate violence,” he ended with this:

I believe that in a world of nameless, faceless thugs influencing our people every day, it is imperative that we become thugs with names and faces just as scary even if in a different way. If we don’t, then we lose.

Yep. He called himself a thug. No, I mean, a “scary” thug.

And if any of you are tempted to think that this Nogy creep is a lone wolf, think again. You can follow the Twitter accounts of any number of  Tea Party Republican conservatives, or you can peruse the comment sections of nearly any right-wing web site, or, heck, you can just tune into any reactionary radio station near you and listen to the same kind of stuff Nogy based his kill-the-traitors screed on:

To the turncoats that sunk us, thank you.  It is now our responsibility to make sure that you are forever remembered in history, in big, bold, letters as the ones who placed Arkansas firmly on the path to Socialism, to the desires of Obama and Sebilius [sic], and who made it easier for future traitors to introduce all kinds of other socialist laws and programs.  You set the precedent,  now I hope that we can do something to make sure the lesson learned by those who represent us in the future is that bad things will happen to you if you follow that precedent.

For some folks in this country, the metaphorical civil war going on over that Scary Negro in the White’s House, is too much metaphor and not enough war.

A Peep Inside The Strange Minds Of Two Missouri Legislators

Jeffrey Messenger was elected in 2012 as a Republican in Missouri’s House of Representatives. He represents the 130th legislative district, about 50 miles east of Joplin. He lives in the town of Republic.

Thanks to his last campaign bio page, we learned that Messenger is a hard working guy with roots firmly planted in rural America. We also learned he owns a business that makes prosthetic limbs for those unfortunate folks who need them, and we found out he “is in the process of building another full time facility in Joplin, Missouri.” Good for him.

And we also learned that Messenger claimed his experience in the prosthetic limb business would somehow make him a better legislator:

Since being involved in Kessler Heasley Artificial Limb Co. Jeff has been able to increase his knowledge in the benefits as well as the pitfalls of Medicare, Medicaid, and Private Insurance, and understands the frustration for individuals when it comes to insurance coverage…

Jeff decided several years ago he wanted to get involved in politics. He feels he has the experience and the know how it will take in Jefferson City to get the job done.

Experience and know-how.  He can get the job done, he said. He “understands the frustration for individuals when it comes to insurance coverage,” he claimed.

Wednesday evening in Springfield, at a town hall with other Missouri legislators, Jeffrey Messenger, the man who understands people’s frustrations “when it comes to insurance coverage,” explained to those gathered why he is opposed to Missouri expanding insurance coverage under ObamaCare.

As reported by the Springfield News-Leader:

Messenger pointed out what he views as potential problems with expansion.

Messenger said that larger businesses will be penalized under the Affordable Care Act if they fail to provide health insurance to employees working 30 hours or more. To avoid the penalty, companies will cut employee hours down to under 30, he said.

These workers, because they work fewer hours and make less, will be more likely to qualify for an expanded Medicaid, and this will add an unanticipated strain to the system, Messenger said. He described it as a kind of loop.

“It just keeps growing and growing and growing,” Messenger said.

You get it? Businesses will screw their employees out of hours so they don’t have to provide them with health coverage, which will in turn make those employees candidates to get health insurance under Medicaid expansion, and therefore we shouldn’t expand Medicaid to help them. It’s all very simple, really. And very cruel.

Messenger not only “understands the frustration for individuals when it comes to insurance coverage,” he is willing to ignore that frustration, or really, to exacerbate it. Oh, by the way, Messenger’s campaign web page informs us that Jeff is “Pro-Life 100%.” Thank God.

As grievous as Messenger’s message to Missourians was during Wednesday night’s town hall, by far the dumbest and most offensive comment made about Medicaid expansion in Missouri was made by another Republican legislator, Lyndall Fraker, who represents folks east of Springfield and lives in Marshfield.lyndall fraker

But before we get to his dumb and offensive comment, Fraker’s campaign bio indicates that he proudly managed the Walmart store in Marshfield, which is interesting since Walmart is planning on taking cynical advantage of ObamaCare by excluding workers who work less than 30 hours a week from its health insurance plans.

Now, Fraker is not responsible for what Walmart honchos do, but he did say his Walmart experience made him realize “what a passion he had to serve others.” Goody, goody, now we’re ready for his comment on Medicaid expansion.

Here is the News-Leader’s account:

Fraker said it would be hard to roll back expansion once it’s happened.

“It’s hard to take candy away from a baby,” Fraker said. He used the metaphor of him and his wife buying a refrigerator. He said if his family couldn’t afford it, their approach would be to wait and see.

Candy from a baby. I can see where health insurance is like candy, can’t you? Sure it is. And people who need health insurance but can’t afford it are like babies. I can see that. And by God we can’t give those babies candy because it will be hard if we have to take it back. They’ll whine and cry and stuff.

And I can see where health insurance is like buying a new refrigerator, can’t you? Absolutely it is. If you can’t afford a new fridge, just wait and see what happens. And if you don’t have a fridge that works, you could store your food in an ice chest. Just don’t count on a Republican legislator to provide you with the ice. And if you don’t have a refrigerator and don’t have any ice, you can just stop eating. Eventually you won’t have to worry about the fridge or the ice.

The News-Leader reported that someone in the town hall “took offense to Fraker’s characterization, and he apologized.”

For what? Why did Lyndall Fraker apologize? For revealing how his mind works? How he really thinks about this issue?

We all should write him and thank him, and Jeff Messenger, for a moment of honesty. This is who these people are, my friends, this is who they are.

Free Pot For Everyone, And Other Budget Fantasies

Many liberals are criticizing Paul Ryan for essentially ignoring last November’s election results, as he released his third very dark, very Randian, budget resolution.

But it’s not that Ryan is acting as if the last national election didn’t happen. It’s that he is acting like he and Mittens actually won the damned election. In what can only be considered flat-out delusion (or that he intends to win a GOP primary in 2016), he offers the country a budget proposal that wouldn’t even become reality if Romney and Ryan had successfully duped a majority of Americans last November.

This monster would: repeal ObamaCare, slash Medicaid and food stamps, kill traditional Medicare, cut Pell grants, create lower tax rates for the rich—yet again. There is apparently no allowance for emergency spending on disasters, or the recognition that our infrastructure is crumbling and we need more not less money to fix it. Tax reform is part of the proposal, but we don’t know what the reforms are. The economic growth assumptions are also shrouded in mystery worthy of the ongoing papal conclave.

Not to mention the blinding hypocrisy of supposedly balancing the budget in ten years by using the $716 billion in Medicare cuts (used to help fund ObamaCare), cuts that Ryan and his fellow Republicans so famously campaigned against in both 2010 and 2012.

And not to mention the breathtaking dishonesty of using the $600 billion in revenue generated by Obama’s insistence on the restoration of the Clinton-era tax rates on high-income earners, which settled the fiscal-cliff nonsense this year.

This is not a serious proposal and Democrats in the Senate, who have now released details of their own budget, should revise their proposal in response to Ryan and the Republicans by including a series of people-pleasing goodies like: free health care, a free college education, forty acres and a Ford for all, a chicken in every pot, and some pot in every pipe.

Democrats can then start budget negotiations from there.

Missouri Medicaid Expansion: A Matter Of Life And Death

Missouri Governor Jay Nixon was here in Joplin on Wednesday.

Susan Redden of the Joplin Globe reported that Nixon was in town “to assert that Medicaid expansion would be a good business decision for the state.” From the story:

With officials of area hospitals and health care providers standing behind him, Nixon told a Joplin crowd that rejecting the Medicaid expansion available under the Affordable Care Act would send tax dollars collected in Missouri to other states where the coverage has been expanded.

“The question is narrow: Will we bring back those federal tax dollars to help the state or not?” the governor said in a presentation at the Robert W. Plaster School of Business at Missouri Southern State University. “If we don’t, other states will get the help, and we’ll pay the bill.”

The article notes that some 300,000 Missourians will benefit from the expansion of Medicaid, and in the words of Governor Nixon,

the people it will help are working folks who otherwise are going to end up in the emergency room.

Naturally, since the expansion will help “working folks,” many Republicans are against it, including leadership in our right-wing-dominated legislature. But the Missouri Chamber of Commerce and some local chambers, but not yet including Joplin, are on board because they recognize the foolishness of rejecting the expansion, just to spit in the eye of Barack Obama.

Expanding Medicaid happens to be good for business and employment:

Nixon cited a study by the University of Missouri suggesting that the additional funding for health care would create 24,000 new jobs in Missouri the first full year of the expansion. And, he said, states that don’t expand coverage could be put at a competitive disadvantage when small businesses are looking to add jobs, which often start on the lower end of the wage scale.

“If businesses are paying the same wage, and workers are getting health coverage in one state and not another, it could make a difference,” he said.

Medicaid expansion is projected to bring back to the state $1.8 billion in the first full year of coverage, and $5.7 billion over three years, Nixon said. “If we take a pass, Missouri residents pay that money in taxes, but it goes to other states,” he said.

As most of us know, the Supreme Court, in upholding the constitutionality of the Affordable Care Act, ruled that the provisions in the law that required states to expand Medicaid coverage to folks earning below 138 percent of the federal poverty level went too far. The Court’s decision allowed states to opt out of the expansion, even while staying in the Medicaid program.

Some Republicans claim our state can’t afford to expand Medicaid. But the entire cost of the expansion is covered by the federal government from 2014 through 2016. Then, until 2020 the states have to cover 5% of the annual cost, and after 2020, the states have to cover 10%. And that’s it.  Providing health insurance to 300,000 working folks in Missouri is a damn good deal.

And it’s a good deal for hospitals and other health care providers, who clearly recognize the foolishness of keeping poor people from getting health insurance. Those poor folks often seek care—expensive care—at emergency rooms, and much of that care—mandated by EMTALA—is uncompensated.

The federal government, through Disproportionate Share Hospital allotments, provides support to hospitals (“safety-net hospitals“) that treat the uninsured who can’t pay. In 2011, that support amounted to $11.3 billion, a little more than one-fourth of the estimated cost ($41.1 billion) to hospitals for providing care to those who can’t afford it.

The Affordable Care Act, because its purpose was to insure people and reduce uncompensated care, lowers federal payments to hospitals that treat those who can’t pay. But because the Supreme Court made the expansion voluntary and because many Republican governors and legislatures hate Obama and ObamaCare, the states who opt out are burdening the hospitals in their states with extra costs.

That’s why here in Joplin Governor Nixon met with local hospital leaders, who have given him their blessing. One of those leaders, Paula Baker, president of Freeman Health System, said,

He didn’t need to sell us on it.

But beyond the finances of the Medicaid expansion, there is the human element. Consider this from The Incidental Economist, a blog dedicated to studying America’s health care system:

First of all, Medicaid is good for health. Let’s start with a simple truth: having health insurance is better than not having health insurance. Not only is health insurance good for health, but it actually saves lives. Medicaid is, of course, health insurance. Therefore, it comes as no surprise that studies show Medicaid improves health. Now some people have garnered a lot of attention by claiming that Medicaid actually hurts people. They’re citing studies that show correlation, not causation. Medicaid doesn’t cause bad health; people who qualify for Medicaid are more likely to have bad health for other reasons. There’s a huge randomized controlled trial of Medicaid going on in Oregon right now, and that’s the kind of study you’d do to prove causation. It’s showing that Medicaid is good for health.

Expanding Medicaid is not only a good thing to do in terms of finances, it is “good for health.” It is good public policy. It is the right thing to do. And it does save lives, as was suggested in the Globe article. A woman named Patricia Bailey was visiting a local Joplin clinic that serves a significant number of folks on Medicaid:

Bailey, 61, of Joplin, said she has been on Medicaid for the past four years. Without it, she said, she wouldn’t have sought treatment that included three hospitalizations.

“I couldn’t have afforded it. I think I’d probably be dead,” she said.

More than the money, more than anything else, as Missourians, as Americans, we should expand Medicaid coverage because for some folks, it is a matter of life and death.

Americans Endorse Socialism, Again

A new ABC/Washington Post poll conducted recently has caused some pundits to focus on the reality that Republicans are having a terrible time convincing most non-Republicans (that’s about 75% of the country, according to this poll) that the GOP is looking out for middle-class interests.

Most folks know where the loyalties of the current  Republican Party lie, and it is not with most folks but mostly with folks with the most.

But as we start thinking about the year to come, and to put the ridiculousness that is the fiscal cliff in perspective, I want to focus on one part of the poll that I am sure will get overlooked by most popular media types: America, as I have argued many times before, has a jones for socialism.

The pollsters asked this question:

17. In order to strike a budget deal that avoids the so-called “fiscal cliff”, would you accept “cutting spending on Medicaid, which is the government health insurance program for the poor,” or is this something you would find unacceptable? Do you feel that way strongly or somewhat?

Now, it might surprise some of you, I know it did me, that only 28% of the respondents said it would be “acceptable” to cut spending on health insurance for the poor. And only 13% felt “strongly” that such cuts were acceptable. A whopping  68% (53% “strongly”) found such cuts “unacceptable.”

Wow.  Think about that.  With all the doom-talk, with all the talk about falling off cliffs, there is still an overwhelming majority of folks in America who refuse to solve our fiscal problems on the backs of poor people.

This holiday season I find that inspiring.

And lest you think I am drawing an untenable conclusion from that datum, a conclusion that concludes America has embraced a rather robust form of socialism, I submit to you another question asked by the pollsters:

17. In order to strike a budget deal that avoids the so-called “fiscal cliff”, would you accept “raising taxes on Americans with incomes over 250-thousand dollars per year,” or is this something you would find unacceptable? Do you feel that way strongly or somewhat?

A staggering 74% of respondents said it was acceptable—54% felt”strongly”about it—to raise taxes on affluent Americans while also saying that any fiscal cliff deal-making should not include the poor.

That, my friends, is an endorsement of income redistribution, of socialism, right here in what right-wingers think is a center-right America.

A Fiscal Fantasy

This morning on MSNBC Ezra Klein made a great point about how most of the talk surrounding Ryan’s budget plan has been limited to the Medicare issue. But there is a lot more to it than that:

What people don’t realize about it is the cuts to other health care programs, primarily Medicaid, are almost twice  as large as Medicare…

Medicaid, of course, is a means-tested health program for low-income folks, including children, the elderly, and the disabled.  More than half of the funding for each state is provided by the feds.

According to the Kaiser Commission on Medicaid and the Uninsured, those Ryan—now Romney-Ryan—cuts Klein referenced, along with repeal of the Affordable Care Act which Romney and Ryan promise to accomplish, will in, say, Missouri mean that somewhere between 46% and 53% of folks who would otherwise be enrolled in Medicaid under current law in 2021 would not be so enrolled.

That represents between 650,000 and 750,000 Missourians whose well-being, unless the state came up with more revenue itself (!), would be sacrificed in the name of budget austerity that has as its guiding principle the idea that rich folks need more tax cuts.

But that’s not all. Klein also makes the point that the Ryan plan is designed to shrink other parts of government spending as a share of the economy, to uncivilized levels by 2050. He  presented this graph:

Klein wrote something remarkable that should be shouted from the housetops (emphasis mine):

The truth is that the Ryan budget’s largest long-term savings don’t come from Medicaid or Medicare or Social Security, or even Medicaid and Medicare and Social Security put together. They come from everything else. Ryan says that under his budget, everything the federal government does that is not Medicare, Medicaid or Social Security will be cut to less than 3.75 percent of GDP by 2050. That means defense, infrastructure, education, food safety, energy research, national parks, civil service, the FBI — all of it. Right now, that category of spending is 12.5 percent of GDP.

Think about that. A government that small could not possibly “establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity” in 2050. But it’s all nonsense, as real-time, Nobel Prize-totin’ economist Paul Krugman pointed out:

Look, Ryan hasn’t “crunched the numbers”; he has just scribbled some stuff down, without checking at all to see if it makes sense. He asserts that he can cut taxes without net loss of revenue by closing unspecified loopholes; he asserts that he can cut discretionary spending to levels not seen since Calvin Coolidge, without saying how; he asserts that he can convert Medicare to a voucher system, with much lower spending than now projected, without even a hint of how this is supposed to work. This is just a fantasy, not a serious policy proposal.

Well, what is serious is the philosophy behind the proposal, which philosophy is based on a fantasy, a fantasy that what is wrong with our fiscal house can be fixed by throwing the poor, the elderly, and the sick in the streets to fend for themselves and by shrinking government to a size that could truly be drowned in Grover Norquist’s bathtub.

The Bad Part Of The Supreme Court’s ObamaCare Ruling And How Republicans May Use It To Screw The Needy

In my post on the health care law ruling yesterday I mentioned I would save for another day what I meant by this:

judging by this decision, I see only two consistent “liberals” on this court, Ginsburg and Sotomayor.

What I meant was their just refusal to join the other seven justices—including the usually sensible Steven Breyer and the ideologically suspect Obama appointee, Elena Kagan*—in ruling unconstitutional (it’s complicated, so see here) any attempt by the feds to terminate existing Medicaid money to states (almost all Republican-controlled states, of course) who might refuse to go along with the ACA’s expansion of Medicaid, an expansion that would enable millions of needy folks to get health insurance.

But, as usual, the needy just don’t have quite enough friends in powerful places.

For those who don’t know, Medicaid, created along with Medicare in 1965, is a federal-state effort designed to provide medical and health benefits to poorer folks, including children, who would otherwise go without all but emergency health care at hospitals. It is funded by both state and federal sources, the funding formula based on per capita income in the various states, with no state going without at least 50% federal funding (the average the feds pay is 57 percent).

The ability to withdraw all Medicaid funding, not just that associated with the expansion, was seen as a big stick in getting reluctant (red) states to do the right thing.  And the Supreme Court—again, including two justices appointed by Democrats—held that the federal government cannot coerce states or penalize them in such a manner, even if it is to do the right thing. Paul Clement, who argued the case for the bad guys, characterized this part of the decision as “really quite significant.”

Yes, it is. Here’s how USA Today summarized it:

The court struck down a portion of the law that would have forced states to accept a major expansion of Medicaid to all Americans earning up to $30,733 for a family of four or risk losing all federal funds under the program.

Roberts called that part of the Affordable Care Act “a gun to the head” by threatening as much as 10% of states’ budgets.

By removing the “gun to the head,” the Court has made it voluntary for the states to  provide expanded health insurance for its neediest citizens, to folks with incomes at 133 percent of the national poverty line.

And even though the federal government is picking up nearly all of the tab for the expansion, inevitably there will be Republican opposition, since that political party is long on hatred for Obama and short on love for the neediest among us.

Don’t believe me? How about this headline and story from the AP:

Top Mo. Republicans oppose Medicaid expansion

JEFFERSON CITY, Mo. (AP) – Top Missouri Republicans say they have no intention of expanding Medicaid eligibility as a result of the Supreme Court’s ruling on the federal health care law.

The story relates that Missouri House Majority Leader Tim Jones will not consider the expansion, and the stripper-lovin’ Lt. Gov. Peter Kinder falsely called it a “break-the-bank provision.”  Obviously, these unkind gentlemen don’t give a damn about the Missourians who would be helped, including doctors who treat patients who can’t pay, nor do they appear to give a damn about Missouri hospitals, most of whom have to absorb themselves or pass on to others the cost of uninsured patients they are required by law to treat.

Reportedly, the White House believes that all of the states will go for the expansion, since they all participate in Medicaid now with considerably less federal funding help than the new law provides.  But as a student of bullheaded Tea Party extremism, I can tell you that I suspect more than a few red states will opt out of providing more health services to those folks—many of whom are ongoing victims of Republican economics—who can’t afford them otherwise.

____________________________

* I had my doubts about Kagan’s appointment two years ago; I was for Diane Wood as Obama’s pick to replace John Paul Stevens.

Throw Medicare From The Train—Part Deux

Here’s the basic outline of House Budget Committee Chairman Paul Ryan’s 2013 budget in one sentence: Ryan’s budget funds trillions of dollars in tax cuts, defense spending and deficit reduction by cutting deeply into health-care programs and income supports for the poor.”

Ezra Klein

The Associated Press story in today’s Joplin Globe (the paper’s version was shortened for publication) summed up the Ryan budget plan nicely:

Mixing deep cuts to safety-net programs for the poor with politically risky cost curbs for Medicare, Republicans controlling the House unveiled an election-year budget blueprint Tuesday that paints clear campaign differences with President Barack Obama.

The AP also reported Mitt Romney’s rather enthusiastic support for the plan:

The House Republican budget rejects the out-of-control spending and higher taxes proposed by President Obama in his budget last month. By proposing prescriptions that will strengthen Medicare for generations to come, it also highlights President Obama’s failed leadership on entitlement reform.

So, now that we know where Romney stands (a rare achievement), let’s look at some of the Ryan plan in broad strokes, as presented by the AP: (follow the link for the details):

The Republican proposal…would wrestle the federal spending deficit to a manageable size in short order, but only by cutting Medicaid, food stamps, Pell Grants and a host of other programs…

The plan calls for steep drops in personal and corporate tax rates in exchange for clearing away hundreds of tax deductions and preferences. It would eliminate oft-criticized corporate tax boondoggles but also tax deductions and credits claimed by the poor and middle class.

To cope with the unsustainable growth of Medicare and the influx of retiring baby boomers, the GOP budget reprises a controversial approach that would switch the program — for those under 55 today — from a traditional “fee for service” framework in which the government pays doctor and hospital bills to a voucherlike “premium support” approach in which the government subsidizes purchases of health insurance.

If that all sounds familiar, that’s because we saw this movie last year. The difference is that this year’s sequel is even gorier (aren’t they always?) than last year’s spine-chilling offering.  And it was meant to be that way, according to Paul Ryan:

We are sharpening the contrast between the path we are proposing and the path of debt and decline that the president has placed us upon.

Sharpening, indeed.

Perhaps most appalling—considering all the cuts in the rest of the budget and the change in Medicare—is this:

The GOP measure also would replace $55 billion in Pentagon spending cuts and $43 billion in cuts to non-defense appropriations set to take effect in January with at least $261 billion in other savings over the coming decade, including curbs to food stamps, federal employee pensions and further cuts to federal health care programs.

As The Hill reported, not only does Ryan’s plan “shield the Pentagon from nearly $500 billion in automatic cuts and roll back some of the $487 billion reduction” already approved, the plan,

also increases national defense spending to $554 billion in 2013, an increase of $8 billion over the $546 billion that was agreed to under the Budget Control Act.

Get that? The GOP budget actually increases defense spending over what was agreed to last year!

All of the above is from neutral journalists. If you want to read progressive takes on the Ryan plan, go to the Washington Post and read Ezra Klein or to the Center for American Progress, which has a series of articles presenting the details of the plan. It ain’t pretty. And there is, as always, the Center on Budget and Policy Priorities here and here.

____________________________________

As for a short, non-partisan analysis of the “premium support” plan for “saving” Medicare, go to Kaiser Health News. Here is part of that analysis:

All plans, including traditional Medicare, would submit bids for how much they would charge to cover a beneficiary’s health care costs. The government would pay the full premium for the private plan with the second lowest bid, or for traditional Medicare, whichever is lower. Beneficiaries would have to pay the difference if they chose a plan that set rates higher. There could be one less expensive plan option, and beneficiaries who chose it would get a rebate for the difference…

But some critics are already arguing that the government-administered option would not be affordable and that it could cause doctors to leave the program. Critics have argued that the government-run plan would attract the sickest people, driving up its costs, while private plans would lure the healthiest.

This plan is the so-called Wyden-Ryan “compromise.” If you have wondered why a Democrat with liberal bona fides—Oregon Senator Ron Wyden—would team up with a right-winger like Paul Ryan to develop a plan to “protect Medicare,” go here and read Senator Wyden’s explanation. (You might be surprised; I was. But it is still unconscionable to give Ryan and the Republicans some political cover at a time like this, when so much is at stake.)

For a readable critical analysis of that Wyden-Ryan plan go here and here and here to get educated. It is essential to know what may happen to a vital social program.

Finally, in case any of us might think the White House will get wobbly-kneed on the Medicare proposal in the Ryan budget, remember this initial statement from Obama’s Communication’s Director Dan Pfeiffer:

We are concerned that Wyden-Ryan, like Congressman Ryan’s earlier proposal, would undermine, rather than strengthen, Medicare. The Wyden-Ryan scheme could, over time, cause the traditional Medicare program to “wither on the vine” because it would raise premiums, forcing many seniors to leave traditional Medicare and join private plans. And it would shift costs from the government to seniors. At the end of the day, this plan would end Medicare as we know it for millions of seniors. Wyden-Ryan is the wrong way to reform Medicare

Domesticating The Dogs

I don’t think there should be a profit motive in health care. I think all the health care dollars should go to care.”

—Elsa Stone, a North Haven, Connecticut, pediatrician

Well, what do you know.  The universe is starting to make sense. 

From Thursday’s USA Today:

HARTFORD, Conn. – In the past decade, most states have turned Medicaid over to private insurance plans, hoping they could control costs and improve care. Nearly half of the 60 million people in the government program for the poor are in managed-care plans run by insurance giants such as UnitedHealthcare and Aetna. 

Connecticut, the “insurance capital of the world,” is bucking the trend.

Beginning Sunday, Connecticut will jettison its private health plans from Medicaid, the state-federal health insurance program. Instead of paying the companies a set monthly fee to cover the health costs of more than 400,000 children and parents, the state will assume financial responsibility.

Why?

Glad you asked:

State officials say the companies, including Hartford-based Aetna, did not fulfill their promise of lower costs and better care.

Take that all of you private-insurance lovers out there.

Notably, our neighbor to the West, Oklahoma, one of the reddest states in the Milky Way, doesn’t trust the private insurers either, and hasn’t for a while:

Oklahoma moved away from private plans in 2005, and officials there say they have no regrets. “While achieving very encouraging marks in both member satisfaction and quality, the cost per member has grown at a very low average annual rate of 1.2% over the last five years,” says Mike Fogarty, Oklahoma’s Medicaid director.

It appears that in Connecticut (and elsewhere, of course) too much money is being spent on things that have nothing to do with health—like, say, profits. The USA Today story cited,

a 2009 state-commissioned report showing Connecticut was overpaying insurers by nearly $50 million a year–about 6% of total expenses.

Other state reports found the plans were spending too little on health services and published networks of doctors that were misleading because many doctors refused to accept Medicaid patients when “secret shoppers” called for appointments.

And, thus, the story touches, albeit indirectly, on a major problem with the very conservative Affordable Care Act:

Many doctors are happy to see the state’s experiment with managed-care plans end. Many had been frustrated with having to follow different rules for different plans. They also complained about payment delays and problems referring patients to some specialists.

You see, because too much worry is exhausted on who gets paid, the folks in the middle—doctors and patients—tend to suffer. The ACA, while guaranteeing everyone health insurance, still keeps in place that profit-minded system.  In fact, Paul Ryan’s budget plan—fully embraced by the Republican Party—would essentially do for older folks, who would have a hard time getting health care, what the ACA does for younger folks, who can’t afford or aren’t able to get health care. 

Yes, it’s true.

An important but little noticed point made in the recent controversial Politifact article, “Lie of the Year 2011,” explains:

Under the current Medicare system, the government pays the health care bills for Americans over age 65. Under the Ryan plan, future beneficiaries would be given a credit and invited to shop for an approved plan on a Medicare health insurance exchange…Ryan’s plan requires private insurers to accept all applicants and to charge the same rate for people who are the same age…

“Ryan basically proposed the Affordable Care Act for future seniors,” said Jonathan Gruber, an economist at the Massachusetts Institute of Technology, who advised both President Obama and Republican Mitt Romney on health care. “I don’t understand how you can like it for future seniors but not like it for today’s needy uninsured. That doesn’t make any sense.”

Of course, it also doesn’t make sense how most people in the country can like Medicare for seniors and not like Medicare for everyone, but Republicans have done such a darn good job of demonizing everything that comes in contact with government that it  is somewhat understandable why there is such cognitive dissonance out there.

Fortunately, some states, most recently Connecticut, are coming to their senses about how health care is delivered in this country, and it’s not through motivating private insurers with profits. And that, despite all the Republican criticism of it, is what is wrong with the Affordable Care Act.  It is an improvement over the dog-eat-dog insurance system we have now, but the dogs are still out there.

Obama, Lincolnesque

It’s hard to know what it happening behind the scenes regarding negotiations over the debt ceiling, but we know that folks on the outside looking in—liberal Democrats and conservative Republicans—are worried about negotiators on their side giving up basic principles in order to make a deal.

Now, don’t get me wrong.  There is no moral equivalency here.  Liberal Democrats are worried that “the big three,” Social Security, Medicare, and Medicare, are under attack, and they don’t much appreciate that President Obama seems willing to at least consider unpleasant cuts to those social programs. 

But that can’t be compared morally with Republicans worrying about keeping taxes low on the wealthy, whether individuals or corporations, or their willingness to risk incapacitating the economy in order to get their tried-and-failed way.  They are a disgusting group, this hard-headed, ideologically-centric band of know-nothings.

How this debt-ceiling thing turns out in the end is unpredictable at this time.  And I know liberals are starting to squirm, and some are starting to squawk, about President Obama’s deal-making skills, and his commitment to hard-bargaining with non-compromising negotiators in the House. 

I feel their pain.

But President Obama’s nature is not to gamble irresponsibly with such things as the full faith and credit of the United States, even if his political opponents are.  His nature is not to risk an economic calamity, that would harm most the very people that liberals want to protect, even if Tea Party Republicans don’t give a flying puck about that economic calamity.  In short, he is seeking the best compromise possible in order to save our economic system from the reckless, ideology-crazed conservatives in Congress.

His discussion this morning at a Town Hall event in Maryland included talk of Lincoln and the Emancipation Proclamation.  He has used Lincoln’s willingness to compromise on the issue of slavery before, so it’s a good bet he has Lincoln’s example at the top of his head, as he seeks to avert economic catastrophe.   He pointed out that Lincoln was willing to settle for only outlawing slavery in rebel states as a means of preserving the union and finishing the fight,  a fight which eventually ended with not only the preservation of the Union, but slavery completely abolished.

I think Obama sees this fight much the same way:  Advance things by compromising, even to the point of making some supporters—like me—angry, in order to keep fighting—fighting that will continue through the 2012 campaign—because he believes he can ultimately win the fight for the Democratic vision of the country.

We shall see about that. Much of it will depend on how far he goes to appease unappeasable opponents.

Some things we are not willing to sacrifice,” Obama said today, but “In the mean time, we have a responsibility to do our job.”  Like Lincoln who gave the South every chance to avoid the Civil War, Mr. Obama is giving Republicans every chance to avoid the catastrophe that what would follow a loss of confidence in America’s fiscal sanity.

It’s easy, and understandable, for liberals in the Democratic Party to voice their concerns over what is happening.  After all, most of this fight is taking place on conservative ground.  But what would they—we—have Obama do?  A majority of the American people—including those who didn’t vote—put radical conservatives in charge of the House and gave them filibuster power in the Senate.  The American people.

This is a delicate situation, both economically and politically.  If Obama sent the signal that he was completely dug in on his side, the markets would react negatively and the economy would already start sinking.  He has to be the grownup. He has to be the pea-eater.

In the end, though, there has to be a line he won’t cross.  Lincoln had his, and the South called what turned out to be not his bluff.  Let’s hope that, as Obama said two weeks ago, Republicans won’t call his bluff.

All liberals can do is hope he is not bluffing, and that he will not surrender.

Is This Crisis Going To Waste?

Jim Wheeler, Globe blogger and frequent commenter here, wrote a piece (Into The Abyss) in which he severely criticized Republicans and mildly rebuked Democrats for their failure to use “a threatened national default” as motivation to tackle entitlement reform.

In other words, Mr. Wheeler doesn’t want this crisis to go to waste.

Here is my reply:

Jim,

I’m glad you singled out the President as the only “adult” in this mess.

Mr. Obama said on Monday,

Now is the time to do it.  If not now, when? 

He also made to liberals what I consider to be a powerful argument in favor of entitlement reform:

…if you’re a progressive who cares about the integrity of Social Security and Medicare and Medicaid, and believes that it is part of what makes our country great that we look after our seniors and we look after the most vulnerable, then we have an obligation to make sure that we make those changes that are required to make it sustainable over the long term.

So the argument I’m making to my party is…if you care about those things, then you’ve got to be interested in figuring out how do we pay for that in a responsible way.

The problem with all that is that those on our side who respect Obama and Obama’s argument, don’t believe he is dealing with honest brokers on the other side.

Mitch McConnell has expressed several times his real priority, which is to oust Obama from office. John Boehner is too weak to make a deal, and Eric Cantor is after Boehner’s job and thus is motivated to thwart any genuine efforts on Boehner’s part to do the right thing.

That is why Obama’s position is a hard sell to liberals. We can’t fathom getting a “balanced” deal from the other side. We think Obama will have to cut way too deep and otherwise give away too much of what we value just to get Republicans to raise the debt limit. It’s last year’s hostage situation all over again, with more at stake this time.

And that is why I resent the use of defaulting on our debts as leverage to make a deal of this magnitude.  It’s not honest, as McConnell’s recent move revealed. Obama has made an unbelievably large offer that would cause him great difficulty among those who trust and support him, if Republicans chose to accept it.  But because Obama made the offer, because it came from his tainted lips, it is unacceptable. Republicans essentially want the cuts without giving anything in return.

Finally, if we believe in democracy, then we ought to let the people decide such large matters through elections. As I have argued before, both parties should cast the 2012 elections as a referendum on what kind of country voters want to live in.

Here are the choices on the domestic spending side:

Smaller government and lower taxes: Which means reduced Social Security and Medicare benefits and a rather severe reduction in Medicaid, reduced funding for education and infrastructure, etc.  Paul Ryan’s dissolution of the Medicare program for those under 55 is just one example of what the country would look like, if people choose this option.

Larger government with higher taxes: Which means making investments in education and infrastructure, etc., and tweaking Medicaid and Social Security to ensure their solvency. That leaves the real driver of long-term deficits and debt: Medicare. How do we fix it under this choice?  Well, more on that later, but suffice it for now to say this: Cost shifting of the kind Paul Ryan outlined is unacceptable; so, too, is perpetual tax increases, which could not keep up with the escalating costs.  Democrats will have to propose a fix along the lines of what Kevin Drum outlined:

We need something…that genuinely has an effect on healthcare costs. Something that reduces the amount we pay doctors, hospitals, and insurance companies. Something that provides incentives for difficult end-of-life decisions. Something that makes credible tradeoffs between the cost of new treatments and the likely benefits. And something that gives taxpayers and patients alike a reason to care about all this. 

I’m in tune with your desire to do something about entitlements, Jim, but I’m skeptical of using the threat to ruin our credit (which would increase our debt problems through the increased cost of borrowing) and reversing our barely-discernible economic recovery as the way a democratic nation solves its problems.

“Colonel” Ozark Billy Long Had A Tough Week

It’s been quite a week for “Colonel” Ozark Billy Long:

Last Saturday he voted to shut down the government. 

On Wednesday, the auctioneer took a few minutes on the House floor to give a scintillating speech that lauded auctions, auctioneers and auctioneering, saying that the first bill he would introduce in his fledgling legislative career would be one that makes the third Saturday in April “Auctioneer’s Day” across these United States. 

I, for one, have always wondered why we’ve never had an auctioneer’s day, and after Long’s speech, now I know.

By the way, if you haven’t seen the dazzling speech, you missed Ozark Billy doing his auctioneer routine on our national debt.  He has talents most legislators only dream of.  If you want to feel proud of southwest Missouri and our newest representative, I suggest you don’t go to YouTube and watch it. If you want to know why I now begin to refer to Ozark Billy as Colonel Ozark Billy, I suggest you do.

On Thursday, despite a plea to start listening “to folks in the middle” (!) from a supporting local newspaper, the Springfield News-LeaderOzark Billy voted against the 2011 budget deal, using a rationale that Long’s own leader, John Boehner, called “total nonsense.”

Today, Friday, Colonel Billy voted to kill Medicare and disfigure Medicaid, and give his rich friends another tax break.

My guess is that, after such a trying week, the proud auctioneer will—belly-up or belly-down—slink to some D.C. bar for a celebratory toast to the end of socialism in America and the possibility of enacting America’s first Auctioneer Day.

Congratulations, Colonel Billy!  And congratulations to all you southwest Missouri voters who made such an obviously inspired choice last November. Rejoice and make merry on your new Auctioneer Day.

But for those of you under the age of 55 who aren’t independently wealthy, pray to the Republican gods that either you die young or that Democrats win in 2012.

Medicare: The End

“Don’t get sick, and if you do get sick, die quickly.”

— former Rep. Alan Grayson, commenting on the “Republican health care plan,” September, 2009

Alan Grayson was roundly condemned for his highly critical remarks during the health care reform debate, which now seems like a decade ago.  But thanks to Paul Ryan we can see that Grayson’s sin was not that he inaccurately pegged Republican philosophy, but that he was simply a little premature in doing so.

Make no mistake about it: Paul Ryan, and by extension Republicans in the House—remember that Ryan was given extraordinary power to speak for them on budget issues—are now on record as lobbying for the destruction of Medicare and Medicaid as we know them.  And Senate Minority Leader Mitch McConnell has tiptoed in and called it a “credible proposal.”

Therefore, it’s now clear just what the Republican health care philosophy is, in terms of the non-wealthy elderly, the poor, and the disabled.  But don’t take my or Alan Grayson’s word for it. Listen to Erskine Bowles and Alan Simpson, co-chairs of Obama’s Fiscal Responsibility Commission. 

They released a letter that criticized House Budget Committee Chairman Ryan’s plan for largely exempting defense spending—imagine that!—and for its lack of tax increases, a necessity, they said, for “broad bipartisan agreement.”  They continued:

As a result, the Chairman’s plan relies on much larger reductions in domestic discretionary spending than does the Commission proposal, while also calling for savings in some safety net programs — cuts which would place a disproportionately adverse effect on certain disadvantaged populations.

Those “certain disadvantaged populations” don’t put much jingle in the GOP collection plate, so why should they give a damn about them?

Even though we know that Paul Ryan’s plan will not become law—at least for the next two years—we do know the details of what Tea Party-drunk Republicans plan to implement if they ever do get the power they crave:

Medicare, the only thing that stands between some older folks and suffering or death, would become a voucher program, one that would leave those without adequate wealth coverage without adequate health coverage. 

Essentially, Ryan’s plan would require future senior citizens to navigate the private insurance market in search of a plan they could afford on the vouchers they are given.  If the coverage they need exceeds the voucher amount—a certainty, thanks to the way the plan is structured—tough shit. 

Of course, the wealthy need not worry.  They get the voucher and, partly thanks to Ryan’s generous tax policy for the wealthy—a reduction of the top rate to 25%—they will have plenty of dough to make up the difference between the voucher and the cost of the insurance. 

Medicaid becomes a block grant program in which states would essentially get to determine how they spend the money the federal government gives them. As Newt Gingrich admitted, this would inevitably mean that some states would short-change the poor, the elderly, and the disabled on Medicaid by making it harder to obtain benefits and by reducing those benefits.  There isn’t any doubt about that.  Just look at what Republicans in the various states are doing now in times of economic stress, times in which benefits are needed most.

Look, I don’t completely blame Ryan and other Republicans for proposing tax cuts for the wealthy while ending health care entitlements for everyone else.  That would be like blaming great white sharks for leg-munching in bloody water.  It’s what they do. 

About the Tea Party Republicans, Ryan told a reporter on Tuesday:

…you look at these people, these new people who just got here. None of them came here for a political career. They came here for a cause. This is not a budget, this is a cause.

A cause.”  Spoken like a bona fide devotee of Ayn Rand.  Rep. Ryan requires his staffers to read Atlas Shrugged, according to New York magazine, which explains a lot about his budget proposal.  Years ago, he told a group gathered to honor Rand,

The reason I got involved in public service, by and large, if I had to credit one thinker, one person, it would be Ayn Rand.

To be a real Randian, as Jonathan Chait put it, one has to believe that,

the central struggle of politics is to free the successful from having the fruits of their superiority redistributed by looters and moochers.

That’s the Tea Party Republican definition of those “certain disadvantaged populations” that Bowles and Simpson mentioned.  They’re “looters and moochers.”

With the advent of the Tea Party and its hostile takeover of the Republican Party, Randian nonsense is now the dominant economic philosophy controlling the actions of GOP congressional leadership. And I suppose the final seal of approval was given to Ryan on Tuesday, when Glenn Beck said he loved Ryan. 

And, by the way, Ryan loved him back.

So, while I don’t put all the blame on Republican sharks for their unseemly ravenous carnivorism, I will blame Democrats if they don’t put the rope Ryan has given them around the necks of every single Republican in the country who won’t denounce the plan to kill Medicare and Medicaid. 

Alan Grayson may have put it somewhat indelicately, but he essentially got it right:

The Republican health care plan is, “Don’t get sick, and if you do get sick, die quickly.”

Republicans Counting On Dumb Voters

Michael Shear, writing for The New York Times, characterizes the upcoming Paul Ryan-Republican House budget plan as “a dramatic political bet“:

The budget they are preparing to embrace in the coming days would slash federal government spending by more than $6 trillion over the next 10 years, mostly by reinventing the nation’s largest social programs in ways that Republicans have talked about for years.

Medicare would become a means-tested support program for private insurance. Medicaid would give states new control over their money for the poor. Taxes on business and the wealthy would come down. Overall spending across a range of programs would be capped.

Shear’s point about the gamble is this:

Packaging long-held Republican ideas into a huge shift in policy, the lawmakers are betting that voters will focus less on the individual things they don’t like and more on the overall impression of the party’s fiscal discipline.

Well, voters would first have to overlook 30 years of the party’s fiscal recklessness before they could focus on today’s soak-the-poor-reward-the-rich incarnation of Republican philosophy.

Are the voters that dumb?

Republicans are betting they are.

America: A Center-Left Country

The latest Wall Street Journal/NBC News poll, unfortunately for Republican budget-slashers, teacher-bashers and union-trashers, indicates the following:

           Positive Feelings Toward:  Negative Feelings Toward:

Teachers                        73%                                  10%

Teachers’ unions            47%                                  30%

Public Employee unions  38%                                  34%

Labor Unions                  38%                                  36%

 

Government should do more:   Government doing too much:

                       51%                                      46%

 

Top issue for government to address:

Job creation and economic growth  56%

Deficit and government spending….40%

Health care…………………………………..   28%

National Security and terrorism……. 20%

Energy and the cost of gas………….  20%

Iraq and Afghanistan……………………  13%

 

Tea Party Supporter?

    Yep:  29%     Nope: 61%

Favor right to collective bargaining for public employees?

    Yep: 77%      Nope: 19%

Cut Medicaid to reduce the deficit? 

    Nope: 67%    Yep: 32%

Cut Medicare to reduce the deficit?

    Nope: 76%    Yep: 23%

Cut Social Security to reduce the deficit?

    Nope: 77%    Yep: 22%

Cut K thru 12 education to reduce the deficit?

    Nope: 77%    Yep: 22%

Cut unemployment insurance? 

    Nope: 55%     Yep: 43%

Raise income taxes on millionaires? 

    Yep: 81%       Nope: 17%

Eliminate tax credits for oil and gas industry?

    Yep: 74%       Nope: 22%

Reduce Medicare and Social Security benefits for wealthy?

    Yep: 62%      Nope: 37%

Eliminate funding for Planned Parenthood?

    Nope 53%     Yep  45%

Judging by the chutzpah of Wisconsin and Ohio and Indiana Republicans—a Wisconsin GOP Senator has referred to the protesters in the Capitol building as “slobs” and “a different breed“— one would think that public employee unions, including teachers’ unions, were hated by a strong majority of Americans. Nope.

Judging by the chutzpah of national Republicans—cutting spending and cutting taxes—one would think that a strong majority of Americans were pining for a smaller government, for government to do less. Not so.

This is a center-left country, as I have said repeatedly.

Obama On Entitlement Reform: Patience!

As I listened to President Obama’s press conference this morning, which was dominated by budget issues, I thought of the recent criticism coming from the Right regarding Obama’s alleged unwillingness to address entitlement reform, typified by a comment by the GOP’s star quarterback on budget issues, Congressman Paul Ryan:

Presidents are elected to lead, not to punt. And this president has been punting.

Hmm. “Punting.”  Why do coaches punt?  Often in a game, when fans and quarterbacks are clamoring to “go for it,” wise coaches punt.  They do so in order to preserve field position, so as to have a better chance of scoring later.  And it is thinking about that “later”—the long-term—for which coaches get paid, not giving in to “the moment.”

As Obama said today:

I’m looking forward to having a conversation, but… the key here is for people to be practical not to score political points. That’s true for all of us.  I think if we take that approach we can navigate the situation in the short term and deal with the problem long term.

Now, that’s  wise coach-talk, no matter what quarterback Ryan says.

In the case of entitlement reform, President Obama said today that “this is going to be a process” and that we need to have patience—something the press doesn’t have, he suggested—much like a coach would tell his star quarterback, who almost never wants to punt on fourth down. 

But the point here is not that the President or his team wins a political game, but that real entitlement reform happens, both to preserve entitlements for future generations and to ensure that they remain safety nets for the most vulnerable among us.  That’s the touchdown in this scenario.

Here was his full response to NBC newsman Chuck Todd’s question about entitlement reform and the President’s debt commission:

Part of the challenge is here is that in this town let’s face it, you guys are pretty impatient…

I think there’s a tendency for us to assume that if it didn’t happen today it’s not going to happen. Well, the fiscal commission put out a framework. I agree with much of the framework, I disagree with some of the framework. It is true that it got 11 votes. That was a positive sign. When it is also true is that the chairman of the House Republican budgeteers did not sign off. He’s got … concerns. I will need to have a conversation with him, and with those Democrats that did not vote for it.

There are some issues in there, that as a matter of principle I do not agree with, where I think they did not go far enough or they went too far. So, this is going to be a process in which each side in both chambers of Congress go back and forth and start trying to whittle their differences down until we arrive said something that has an actual chance at passage. And that is my goal. My goal is to actually solve the problem. It is not to get a good headline on the first day. My goal is that a year from now, or two years from now, people look back and say we started making progress on this issue.

The key to achieving an agreement on how to reform entitlements is, as Mr. Obama put it, to make sure that both parties get “in the boat at the same time, so it doesn’t tip over.”  In other words, to prevent demagoguery by leaders in either party, nobody is going to go it alone.  

Obama’s latest budget, which he knows is not the final word on the subject, was an attempt to send a signal to everyone that he is serious about tackling deficit spending—”stabilizing the current situation,” as he put it—even though it dealt only with discretionary budget reductions. 

Today’s press conference was designed to send the message that he is willing to compromise on entitlement reform, as long as there is someone reasonable on the other side to deal with.  He thinks there will be, although he expects “all sides will have to do some posturing on television” before it’s all said and done.

Far from the hysteria surrounding our deficit and debt issues—many conservatives routinely refer to failure to radically cut spending as America “going off the cliff”—Obama’s demeanor and his conversation today was reassuring.  He was calm, sober, and free from the anxiety that characterizes much of the debate, particularly among those who want to use the debt problem as an excuse to kill government.  He was also confident about progress and its ancillary benefits:

In terms of the markets, I think what the markets want to see is progress. The markets understand that we’re not — we didn’t get here overnight and we’re not going to get out overnight. What they want to see is that we have the capacity to work together. If they see us chipping away at this problem in a serious way, even if we haven’t solved 100% of it all in one fell swoop, then that will provide more confidence that Washington can work.

And more than anything, that’s not just what the markets want, that’s what the American people. They just want some confirmation that this place can work. And I think it can.

The underlying message from Coach Obama is that it’s not necessary to panic.  Act like adults, get in the huddle together, and get the job done. 

Time will tell whether the President will give away too much in any possible compromise with seemingly unbending House Republicans, but I was encouraged by his statement that his deficit commission did recommend some things that he disagreed with on principle. And he reaffirmed today his opposition to tax cuts for the wealthy.  Although those tax cuts contribute to the deficit, more than that they symbolize the Republican duplicity on the deficit issue. Obama said,

… when it comes to, over the long-term, maintaining tax breaks for millionaires and billionaires, that will mean additional deficits of $1 trillion. If you’re serious about deficit reduction, you don’t do that.

Finally, the President essentially challenged Americans to have an “adult conversation” about national priorities, about “what’s important, and here’s how we’re going to pay for it.”  You want a strong military?  Veterans Benefits? Health care for seniors?  Want to help your neighbors during a natural disaster?  That stuff requires taxes. At one point he said,

If we’re cutting infant formula to poor kids, is that who we are as a people?

Ultimately, the answer to that question of identity rests with the American people. Those things do need to be discussed, and Mr. Obama and the Democrats need to keep reminding all of us that we will have the kind of government we are willing to pay for or else we will see a gradual decline—not a precipitous drop—in American fiscal and social well-being.

And for my money, President Obama is the leader in these times of choice, even though Republicans in Congress—and ultimately the people who sent them there—may very well choose decline over progress.

Republicans Believe In Socialism Too

Paul Broun, a Republican congressman from Georgia, tweeted the following last night as part of his running commentary on Obama’s State of the Union speech:

Now, that’s not really surprising, considering that Broun, a proud tea partier, has compared the President to Hitler, has claimed Obama has shown signs of being a Marxist, and has assured us previously that Obama is a socialist.

Oh, yeah. Broun is also part of the Republican Party Death Panel Brigade. He wrote the following in 2009 during the long hot summer of the health care reform debate:

Sadly, it’s senior citizens who will be hit hardest by Obama’s new plan…

When mama falls and breaks her hip, she’ll just lie in her bed in pain until she dies with pneumonia because her needed surgery is not cost efficient.  [emphasis in original]

So, that gives you an idea of what kind of guy Dr. Paul Broun is. 

But let’s return to his tweet.  He said,

Mr. President, you don’t believe in the Constitution. You believe in socialism.

Keep that in mind as you read the following paragraph from the Republican rebuttal last night, delivered by the GOP’s Budget Czar, Congressman Paul Ryan:

We believe government’s role is both vital and limited — to defend the nation from attack and provide for the common defense … to secure our borders … to protect innocent life … to uphold our laws and Constitutional rights … to ensure domestic tranquility and equal opportunity … and to help provide a safety net for those who cannot provide for themselves.

Get that? “Government’s role is…to help provide a safety net for those who cannot provide for themselves.”

To paraphrase Paul Broun’s tweet,

Mr. Ryan, you don’t believe in the Constitution. You believe in socialism.

Lawrence O’Donnell was the first to point out this now-glaring admission by a GOP spokesman.  He cited Ryan’s safety net principle and said it was,

…a socialistic notion advanced first by Bismarck now adopted in full embrace—full official embrace—by the Republican Party: “We believe in a safety net for those who cannot provide for themselves.”  That’s not in the Constitution but it’s now Republican doctrine.

So, even though Paul Ryan’s response last night was otherwise full of half-truths, quarter-truths, and falsehoods, it is nice to know that we can stop arguing about whether America is a center-right country. It’s not. Mr. Ryan has acknowledged the truth: Americans, including Republican Americans, like their socialistic government.

Just in case any doubt remains about that truth, here is a Gallup poll conducted less than two weeks ago:

As you can see, there is no difference between Republicans and Democrats when it comes to cutting Social Security: only one in three would support cuts in the program.  In other words, nearly two-thirds of all folks say, “Keep your hands off my socialism.”

Likewise, there is very little difference between red staters and blue staters when it comes to supporting cuts in Education and Medicare, both socialistic endeavors. Most folks don’t want to cut them.  And although the biggest difference between the two parties comes under “Anti-poverty programs,” it is amazing to me that a majority of Republicans—many of whom have been weaned on Welfare Queen propaganda –don’t want to cut those programs either.

Socialism now!  Socialism forever!

The Case Against Libertarianism, Against Fear

When I was a child, I spake as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things. 

—1 Corintians 13:11

I have often chided libertarians and libertarian-ish conservatives for embracing a “childish” philosophy, one that worked well when we were cutting and shooting our way to the Pacific, living out our self-serving Manifest Destiny.

But it’s time we put away childish things.

America has matured; it has blossomed into the most powerful nation in the history of civilization.  And as it has developed and gained world prominence and dominance, its Constitution has remained the preeminent document guarding liberty and justice for all Americans, partly because courageous interpreters dared to understand it in terms conducive to life in the modern world.

For the moment, libertarians and social conservative zealots and haters of either our progressive or pigmented president—take your pick—are playing nice as they join together to rout the Democrats this November.  But as the conservative fanatic Richard Viguerie suggested the other day in the New York Times, after November 2, the Peace Train will collide head-on with the Soul Train—the fight will be on in earnest for the heart and soul of the Republican Party.

But for now, let’s look briefly at libertarian philosophy through the eyes of one of its most famous national proponents, Barry Goldwater, whom George Will married to the Tea Party movement in today’s Joplin Globe:

In 1964, the slogan of the Republican presidential nominee, Barry Goldwater, was “A choice, not an echo.” Forty-six years on, the tea party is a loud echo of his attempt to reconnect American politics with the tradition of limited government.

I have owned a copy of Goldwater’s, The Conscience of a Conservative, for more than 25 years. The book was first published in 1960, four years before Goldwater was overwhelmingly rejected in his run for the presidency.  The following is an excerpt from the book that sounds eerily similar to what one might hear today, as teapartiers temporarily coalesce around demands for a drastically smaller government, some even calling for an end to what libertarians love to call the Welfare State: Social Security, Medicare, and Medicaid:

The long range political consequences of Welfarism are plain enough: as we have seen, the State that is able to deal with its citizens as wards and dependents has gathered unto itself unlimited political and economic power and is thus able to rule as absolutely as any oriental despot.

Unlimited political and economic power“?  “Oriental despot“?  Keep in mind that was in 1960, and Medicare and Medicaid were still liberal dreams, not to come until 1965.  One would think that after 50 years of even greater “Welfarism” than Goldwater could imagine in 1960, today we would all be bowing to our oriental despot, given a 50-year reign with “unlimited political and economic power.”  

But there just isn’t any oriental despot around, and as our elected President Obama struggles to use the federal government to lift us out of our economic doldrums, one can hardly say the feds have “unlimited” anything, especially “political and economic power.”

Such extremist talk was silly in 1960 and its just as silly today coming from platforms at Tea Party rallies or from 30-second television spots.  In fact, it is embarrassingly immature talk, and fortunately we have half a century of evidence that such fears are cynical and baseless.  Despite an increase in the role of government in overseeing our social well-being, our government is not tyrannical and we still enjoy our liberties.

In 1960, not only was there no Medicare and Medicaid, but the top marginal tax rate was a whopping 91%. Today’s top marginal rate is 35%. Hardly a sign that we are slouching toward oriental despotism.

As far as Social Security, always an object of libertarian and conservative angst, in 1960 the government only taxed the first $4,800 of income at a rate of 3%.  Today, the tax rate is more than twice that and it applies to all earnings up to $106,800. Yet despite that increase, which would have terrified the 1960 Goldwater, there still is no oriental despot on the horizon. 

In fact, Social Security is wildly successful—USA Today reported that the program “kept 14 million seniors above the poverty level” last year. Yet, despite that success, anti-government sentiment is as thick today as when Goldwater wrote in 1960:

Let welfare be a private concern. Let it be promoted by individuals and families, by churches, private hospitals, religious service organizations, community charities and other institutions that have been established for this purpose.

You hear this argument a lot from libertarians and conservatives.  In fact, it is one of their core beliefs that taxing citizens to pay for social programs is illegitimate, amounting to “theft.” The idea that taxation is stealing is creeping into the minds of otherwise sober Americans, who have begun buying into the notion that the government has no business in promoting the general welfare by establishing government social programs. 

Yet what we don’t hear from liber-cons is, what happens if we leave to private concerns all the needs of the needy and those private concerns aren’t all that concerned?  Before Social Security—when private concerns were free to promote the welfare of the poor—seniors were likely to die in poverty. The estimated poverty rate for the elderly was between 70 and 90%.  By 2008, it had dropped to less than 10%.

And whether one thinks that improvement was because of or in spite of Social Security and other “entitlement” programs—programs that are now threatened by Tea Party hysteria—there is simply no denying that the fears that have always accompanied an increased federal role in promoting the general welfare—that promotion rooted in the Constitution itself—are never realized.  Never.

We are not ruled by a despotic federal government, oriental or otherwise.  Goldwater’s State does not have “unlimited political and economic power.”

And contrary to libertarian assumptions, federal involvement in the well-being of the less fortunate, in the well-being of the elderly, has not led to less freedom, but to more.

Because thanks to Social Security, Medicare, and Medicaid, more Americans enjoy the “blessings of liberty” today than at any time in our history.

Why Republicans Need New Ideas

Cal Thomas poked a little fun at the Republican Party through his column, which was published yesterday in the Globe

It seems that House Republicans have put up a new website to solicit “ideas for a new policy agenda.”

Now, since I can’t improve much on what Cal Thomas wrote about the latest scheme to impregnate the GOP with new life, here it is:

If they have run out of good ideas that work and can improve the country, maybe it’s time for them to leave office and allow people with good ideas to serve in their place.

It’s too bad he didn’t stop there, but unfortunately he continued:

We know what works and what doesn’t. Is there any doubt that we are under a crushing load of debt because we spend too much on “entitlements” that are really just bribes for votes? Aren’t individual liberty and economic independence good ideas?

Let’s leave aside the fact that all of us—Republicans and Democrats—make the claim that “individual liberty and economic independence” are “good ideas.”  What matters is how we think we can achieve them for as many people as possible.

But Thomas’ dumb statement that somehow “entitlements” are “just bribes for votes” is indefensible, though not uncommon among the Limbaughtomized legions on the right.

I wish Republicans would have the guts to conduct a nation-wide campaign against Social Security and Medicare by standing on their Tea Party podiums and telling the elderly that those programs are nothing more than enticements to win votes.

I wish the GOP would adopt a platform that made the claim that Medicaid was designed to give poor children medical care in exchange for the votes of their parents.

How about the Department of Defense? Do we increase its budget every year just to get, historically, the anti-communist vote, and, these days, the anti-terrorist vote?  Or is there a real threat out there and thus a real need for a strong defense?

But just to illustrate how deeply Cal Thomas drinks from the well of contradiction, here is what he said—in the same damn column—on the issue of education:

Eliminate the Department of Education…Allow for school choice. The initial focus will be on disadvantaged children who have proven that they can learn in the right environment and with the proper encouragement and motivation. The cycle of poverty will be broken and African Americans, especially, will thank Republicans by returning to their pre-Roosevelt roots and voting for them out of gratitude for saving their children.

What?  In the first place, if there is no Department of Education, how can there be an “initial focus” on anything, much less “disadvantaged children“?  Who’s going to do the focusing, Cal?  The states?  You mean those same states that had separate schools for blacks and whites?  Those guys?  And in any case, we are talking about state “government,” right?

Second, like most of the conservative “solutions” to our problems—cutting taxes, for instance—they are nothing more than ideology masquerading as hope. If breaking the “cycle of poverty” were as easy as sinking the Department of Education and opening up the schools to “choice,” who wouldn’t be in favor of that?  Do conservatives really think that liberals value government bureaucracy for its own sake? Do conservatives believe that liberals don’t care about the poor? Huh? 

That kind of thinking is why I am The Erstwhile Conservative.

As President Obama told Republicans during the healthcare reform debate, if the simple solutions they offered would work, who wouldn’t want to do them?  And a better question is: Why didn’t Republicans do them when they had the power?

But unbelievably galling is the unmitigated hypocrisy of Thomas declaring that entitlement programs (mostly Democratic ideas) were merely bribes for votes and then declaring that abolishing the Department of Education and allowing school choice (mostly Republican ideas) are noble attempts to improve the lives of the disadvantaged—which just happen to create grateful black Republican voters.

If this is the best that Republicans can do,* no wonder they need a website to solicit new policy ideas.

____________________________

 *Look, I know that Cal Thomas wouldn’t necessarily claim to be a Republican. However, he can run from the party whose general ideas he has defended for years, but he can’t hide.

Medicare, Medicaid, and Magic

Scott Meeker’s well-composed article in Thursday’s Joplin Globe was about a courageous 26-year-old, Curtis Almeter, from Anderson, who is preparing for a double lung transplant to counter the ravages of cystic fibrosis, a genetic disease he shares with his 18-year-old brother, Tim.

The article focused on Mr. Almeter’s ability to maintain his love for photography while struggling with his disease, but I want to focus on this:

Last week, Almeter went active on the transplant list. He and his mother are staying at Barnes Lodge [at Barnes Jewish Hospital in St. Louis] and will soon move to a duplex near the hospi­tal. The call informing him that a donor has been found could come at any time. Today, perhaps, or maybe a year from now.

On a TV near where the mother and son sit, U.S. Sen. Pat Roberts of Kansas is talking about his thoughts on the health care reform bill.

Almeter qualifies for Medicare and Medicaid, which will cover much of the transplant cost.

“We didn’t know that initially,” says Karen Almeter [Curtis' mother]. “It was good news…one less thing to stress over.”

God only knows what this family would do, were it not for those magic words, Medicare and Medicaid, which will cover most of the estimated $600,000 cost of the lung transplant.

Those “magic” words, which, of course, are really just the product of our collective agreement that folks like the Almeters shouldn’t have to choose between treatment and bankruptcy on the one hand and suffering and death on the other.

But these days, in the minds of some, those words, Medicare and Medicaid, stand for bloated, wasteful, “socialist,” government programs, and are used as props for intense criticism of Democratic efforts to reform our health care system.

At least part of those Democratic reform efforts are directed at people who don’t qualify for Medicare and Medicaid—people who fall between the cracks of our system—who have jobs but no or inadequate insurance, and who have to worry about bankruptcy when faced with their own $600,000 bill for medical treatment or who simply have to waive treatment and suffer through until the end.

And, of course, many do suffer through until the end, as studies show.  Thousands of Americans die each year for lack of health insurance, and we need to fix the system that tolerates such outcomes, instead of carrying swastika-emblazoned placards to tea parties and singing the word “socialist,” as part of the Pale Face Choir.

Since Scott Meeker’s article referenced Republican Sen. Pat Roberts, our Kansas neighbor, who not only opposes the Democratic plan, but who happened to enjoy more than $500,000 in contributions from “medical interests,” in his last campaign, I thought it would be nice to watch Stephen Colbert adeptly skewer the senator, a few months ago: 

 

[Globe Photo: Roger Nomer]

Learning To Live With Compromise

Johnnykaje, fellow Globeblogger, started me thinking about something, when she commented on a piece by asking a hypothetical: Would it be good or bad, if the Blue Dog Democrats changed parties?

I began thinking about the frustration that many Democrats (not necessarily Johnnykaje) feel over the fact that, despite having rather large majorities in Congress (258 to 177 in the House, 58-40-2 in the Senate) and Barack Obama in the White House, conservatives—whether they call themselves Republicans or Democrats—still seem to be able to block legislation most Democrats want to see passed.

And while I share that frustration, the wrong thing to do would be to force out—through some kind of ideological litmus test—those Democrats who only marginally fit the traditional Democratic profile.  That would essentially guarantee conservative victories, so it’s a non-starter, as all the leaders in the Democratic Party realize, but it’s damned tempting.

But part of the Democratic frustration stems from the fact that historically, when Democrats enjoyed strong majorities, great things were done.  In 1935, Social Security was passed under Democratic leadership, not just in Congress, but in the person of Franklin Roosevelt. In 1965, Medicare was passed, again under strong Democratic leadership from Congress and Lyndon Johnson.

So, I looked at the composition of those Congresses from those two years, and here’s what I found: The Democratic majority in both houses was not just strong, but unassailable. 

Here’s a breakdown, keeping in mind there are 58 Dems in the current Senate and 258 Dems in the current House:

1935 U.S. Senate

Democrats 69       Republicans 25       Other 2     

[Missouri:  Democrats 2]

1935 U.S. House of Representatives

Democrats 322   Republicans 103    Other 10  

 [Missouri: Democrats 6  Republicans 1—Yes, it was the 7th District!]

1935 Legislative Highlights

Social Security Act, which included Aid to Dependent Children

National Labor Relations Act, which protected union organization

Rural Electrification Act

_____________________________________________________________

1965 U.S. Senate

Democrats 68   Republicans 32  

[Missouri: Democrats 2]

1965 U.S. House of Representatives

Democrats 295   Republicans 140 

[Missouri: Democrats 8  Republicans 2—7th District again]

Legislative Highlights

Medicare and Medicaid (Social Security Act of 1965)

Voting Rights Act

Freedom of Information Act

_____________________________________________________________

Interestingly, today’s Missouri delegation—1 Democrat and 1 Republican in the Senate and 4 Democrats and 5 Republicans in the House—is by 1935 and 1965 standards, grossly skewed in favor of the Republicans.

So, when one stops and considers how powerful the Democratic Party was in the eras when Social Security and Medicare and Medicaid were passed, some of us probably expected too much with the relatively small majorities the party has today, and we’re going to have to learn to live with the word “compromise.” 

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